The diving medical detectives: when diving medicine books are completely wrong, Part II of DOI: 10.13140/RG.2.2.15199.79528

Abstract

Abstract / Methods / Results:
as per Part I.
i.e.: DOI: 10.13140/RG.2.2.15199.79528

We compiled lists/descriptions of errors found in the standard
diving medicine literature. We scanned our diving medicine archives
and looked there for already existing error-reports; typos etc. were ignored.
Severe errors are appearing more frequently in monographs. Omnibus
Volumes, written by teams of experts, are obviously more resilient to errors.

Discussion / Recommendations:
Single authors / editors should consult with expert teams prior to publication.

If you want to contribute s.th. to our list,
we would be very happy if you send
an e-mail to our head of lab: director@smc-de.com

Full text

1
The diving medical detectives:
when diving medicine books
are completely wrong
17.09.2021, Part II
Miri Rosenblat, TAU
Nurit Vered, Technion Haifa
Yael Eisenstein,
SubMarineConsulting
DOI: tbd.

2
The diving medical detectives:
when diving medicine books
are completely wrong, Part II
Abstract / Methods / Results:
as per Part I:
DOI: 10.13140/RG.2.2.15199.79528
Severe errors are appearing more frequently in monographs. Omnibus
Volumes, written by teams of experts, are obviously more resilient to errors.
Discussion / Recommendations:
Single authors / editors should consult with expert teams prior to
publication.
If you want to contribute s.th. to our list, we would be very happy if you send
an e-mail to our head of lab: director@smc-de.com
(That is: to be continued with Part III  )

3
 [75]
p. 60, Fig. 4-10 bottom; maybe, this is not a real,
severe error, but the original manual from the
ORCA Edge® (LHS) does not mention any
„Experience“. The „Edge“ was coined by Dan Orr,
as an „Electronic Dive Guide“ …
Since this was an eyecatcher for us, we decided to scrutinize this page
in-depth, and found more …

4
 [75], continued
p. 60, top, Tables 4-1 & 4-2; if you ignore the somewhat
misleading legend (LHS) then table 4-1 is self-consistent:
if you start with the M0-values in row 4, divide these by 33
you get the Tissue ratios in row 3, dividing these ones by .79
you get the Haldane ratios in row 2:

5
 [75], continued
p. 60, top, Table 4-2; the M0 values from Table 4-1 should
then appear in Table 4-2 as the 2nd. row, i.e. SAD = Dnext = 0;
this is OK for HT 5 & 10 min (yellow display). But for the HT 20 to 120 min
these M0 do not match. Especially the M0 with 33 fsw for HT 240 min would
imply zero-supersaturation: a little bit annoying for real-world diving…

6
 [75], continued
On p. 59 it is insinuated that these M-values have
something to do with the US Navy.
But by comparison with
the ultimate source
on M-values,
i.e. Bob Workmans
NEDU Report 6-65 [a];
on p. 31 we found that
neither all the M-values
(2nd. column, D = 10 ft.)
as such and as well, nor
the ΔM match, i.e.
the Tables 4-1 & 4-2
are,
to put it mildly,
only partially useful to
the inclined reader.

7
[4], [4a], [5], [5a], [65], [234]:
In part I we promised to have a look at our collection of Albert Alois
Bühlmanns most prominent books.
[65]
[4] [234]
[5]
[5a]
[4a]

8
 [4], [4a], [5], [5a], [65], [234]
Basis of the following slides # 8 - 14 are the
presentations of Albi,
pls. cf. the references [b] & [c].
[234] & [4]:
Since [234] is the english version of [4], it should be an exact translation:
It is not.
The a-& b-coefficients for the ZH-L12 differ for a couple of the compartments,
(# 3, 7, 10  16; red display on the next slide) and, thus, a couple of the
calculated run-times and decompression table comparisons diverge between
the 2 books (for eg. p. 31).
An a-posteriori validation, like the one we did in [c], will therefore not work.
[234] finds the ZH-L12 set on p. 27, in [4] on p. 27; pls. cf. the next 2 slides:

9
 [234], p.27:

10
 [4], p. 27:

11
[65], p. 158, pls. cf. next slide:
The b-coefficient of compartment # 4 (HT= 18.5 min) is 0.7825
(yellow display).
By using AAB‘s own formula to derive the a- & b-coefficients from the HT
(formula ibd. on p. 129) it should be 0.7725
For real-world diving this is fortunately positive:
the tolerated inert-gas pressure pt,tol goes down from ca. 2.05 to ca. 2.03 Bar
As well for compartment # 5 the b-value, derived by the formula on p. 129,
is 0.81254991 (= 0.8125) but here rounded up to 0.8126 (red line).

12
[65], p. 158:

13
[65], p. 114:
instead of 1.1  1.24
[65], p. 119:
instead of the old ZH-L coefficients; with the 50:50 balanced new ones
(0.3723 & 0.946) it should read 0.9968
[65], p. 12, Tabelle 1:
for 1 Bar inspired air the Vol.-% of N2 & O2 do not match (col. 3); it
seems rather like alveolar air …
the conversion factor from 1 Bar = 750.06 mm Hg seems odd,
since the 1st. diver-ballpark yields 760/1013 = 750.24.
750.2 is used in all standard references, i.e.: [62], [63], [75], [178].
By consulting the ultimate source for diving physicians on
pressure-conversions [110] on p. 893, Table A-3, there yields as well:
1 mm Hg = 1.33323 * 10 -3 Bar

14
 [65], p. 146, Tabelle 22:
for this SAT-dive on air to 30 m the pinert, max is ca.
4 * 0.8 = 3.2 and not 3.6 Bar.
Either this table was calculated with another mix, which is not indicated,
or to another depth (37 m @ air), which is not indicated as well.
However, a SAT dive with air to 36.8 m fresh water would yield the used
pinert 3.6 Bar; the decompression-time with 54 h on air,
starting @ 23 m could be confirmed via DIVE [d],
pls. cf. the attachment, slide #17. Because this example SAT dive has a long
history, starting with [4] in 1983, we assume, that the then published ZH-L12
has been used to create Table 22 and not the new ZH-L 16 from [65].
[65], p. 189, Tabelle 31:
(only for the sake of completeness: the entries at
Nr. 2 do not match the cited source from DAN / DSL)

15
References:
[a] Workman, R.D. (26 May 1965) Research Report 6-65,
Calculation of Decompression Schedules for Nitrogen-Oxygen and
Helium-Oxygen Mixtures, USN NEDU, AD #620-879
[b] Salm, Albi (August 2021) Dekompression: Kapitel 14, S. 368 - 372:
Fehlerchen im Bühlmann Konvolut
[c] Salm, Albi (October 2020) ZH-L12 : Validation of an old (1982)
experimental Heliox jump dive (30 m, 120 min);
DOI: 10.13140/RG.2.2.24608.20482/1
[d] Rosenblat, Miri; Vered, Nurit (07 / 2021) PoC for DIVE Version 3_10,
http://dx.doi.org/10.13140/RG.2.2.28123.69924
*************************************************************************************
[75] "Bove and Davis' DIVING MEDICINE", Alfred A. Bove, 4 th. edition,
Saunders 2004, ISBN 0-7216-9424-1
[110] The Underwater Handbook: A Guide to Physiology and Performance for
the Engineer; Shilling, Werts, Schandelmaier; Plenum Press N.Y., 1976, ISBN
0-306-30843-6

16
References , continued:
[4] Dekompression - Dekompressionskrankheit, A. A. Bühlmann, Springer,
1983, ISBN 3-540-12514-0
[4a] Bühlmann, A. A. (1990): Tauchmedizin (Barotrauma, Gasembolie,
Dekompression, Dekompressionskrankheit), zweite Auflage, Springer, ISBN:
3-540-52533-5
[5] Tauchmedizin (Barotrauma, Gasembolie, Dekompression,
Dekompressionskrankheit) A. A. Bühlmann, Springer, 1993, ISBN 3-540-
55581-1
[5a] Bühlmann, A. A. (1995): Tauchmedizin (Barotrauma, Gasembolie,
Dekompression, Dekompressionskrankheit, Dekompressionscomputer),
vierte Auflage, Springer, 1993, ISBN: 3-540-58970-8
[65] "Tauchmedizin.", Albert A. Bühlmann, Ernst B. Völlm (Mitarbeiter), P.
Nussberger; 5. Auflage in 2002, Springer, ISBN 3-540-42979-4
[234] Bühlmann, Albert Alois (1984) Decompression - Decompression
Sickness, Springer, ISBN: 3-540-13308-9, 0-387-13308-9,
e-book 978-3-662-02409-6

17
Attachment: the SAT dive with DIVE 3_10
 Adjusting Pamb to 1,000 mbar:
„L“ „1.0“
 Loading the 1983 (german) ZH-L12 N2-coefficients (Δ):
„NC“ „8“
Input of the SAT profile, depth = 36.8 m, time 6000 min:
„d“ „36.8“ „6000.“
Check of decompression:
„a“
yields 
The ceiling with 22.73 m
and the
TTS 3,241 min / 60 = 54.02 h
confirm
[65], p. 146, Tabelle 22.
(Δ): with the new ZH-L 16
coefficients the TTS is
ca. 61 h

18
(un-official) Coda of Part II:
We from the lab (Miri, Nurit & Yael) wanted urgently
to push this one out to RG on the morning of 09/17,
even if there is now no proof-reading & no peer-review …
This is a ןגראמ טוג! to a very special mensch, who happens
to be our boss, presently he is on SAT in the Aegean: